Madam, - The impending medical consultants' contract negotiations are widely perceived to be critical to necessary reforms in the delivery of health services. In a situation where 80 per cent of the health expenditure is on salaries, decisions made now will have major impact on the service moving forward.
The current contract pays the consultant up to €160,000 for working a notional 33 hours a week to look after patients in the public system. With now nearly half of the population having health insurance the consultant can levy professional fees on these patients. He thus gets paid twice for looking after nearly half his patients. Should not these fees be paid to the hospital which pays the consultant to look after all the acute admissions to the hospital?
Consultants have recently urged the Government to review the current system for dealing with medical negligence. They claim that in Ireland consultants are sued more than in any other European country. Could this be related to overworked consultants? When one sees the private income generated by many specialists, many even in excess of €1 million a year, this must reflect excessive working hours if they comply with their 33-hour public commitment. Should their total working week be limited? Junior doctors are legally limited to 45 hours a week.
As the new contract negotiations commence one should bear in mind that consultants will wrap their demands up in a desire to improve services to patients. It must be clear that their priority and focus is their terms and conditions and these will likely be hidden in shroud-waving and protests of Government inadequacies. Undue submission to these very well paid professionals' demands will limit the expenditure on other expansions of numbers in the health service. - Yours, etc,
Dr SEAN HOLOHAN, Leinster Court, Rathmines, Dublin 6.